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CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 01): 103-113
DOI: 10.1055/a-1647-8601
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Patienten relevanter Nutzen und Therapieeffekte in der Stimulationstherapie bei schlafbezogenen Atmungsstörungen

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Armin Steffen
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Zusammenfassung

Für die Therapie verschiedener schlafbezogene Erkrankungen und das Schnarchen stehen mittlerweile mehrere Neurostimulationsverfahren zur Verfügung. Zur Behandlung der obstruktiven Schlafapnoe (OSA) existieren überwiegend Daten für die atmungsgesteuerte Hypoglossusnervstimulation (HNS), welche die Senkung der Tagesschläfrigkeit in der Epworth Sleepiness Scale (ESS) in zahlreichen Publikationen übereinstimmend und für mehrere Jahre stabil um gut 5 Punkte zeigen konnte. Die schlafbezogene Lebensqualität im Functional Outcomes of Sleep Questionnaire erbringt in mehreren Kohorten eine Besserung um gut 2 Punkte. Zahlreiche Arbeiten zeigen eine durchschnittliche Nutzung von 5 bis 6 Stunden. Unter Berücksichtigung kürzerer Nachsorgeintervalle und kleinerer Kohorten sinkt der ESS bei der unilateralen kontinuierlichen HNS um 4 und bei der bilateralen um 3 Punkte. Zur Behandlung der zentralen Schlafapnoe ist die transvenöse Stimulation der Nervus phrenicus zugelassen, bei welcher sich in einer Schlüsselstudie mit fünfjähriger Nachbeobachtung der ESS um 3 Punkte gesenkt werden konnte. Die Therapiezeit beträgt in einer Arbeit gut 5 Stunden. Mit der enoralen Stimulationstherapie gegen das Schnarchen konnte der ESS um gut 2 Punkte gesenkt und die schlafbezogene Lebensqualität sowohl des Schnarchenden als auch des Bettpartners gesteigert werden. Die Adhärenz zum täglichen Training für die nächtlichen Effekte wird mit 83% angegeben. Sowohl für die HNS, Phrenicusstimulation als auch die enorale Stimulationstherapie laufen weitere (Register-)Studien bzw. sind angekündigt, welche Patienten relevante Endpunkte berücksichtigen.

Schlüsselwörter

Schlafapnoe - Schnarchen - Patienten-Benefit - Neurostimulation - Hypoglossus - Phrenicus


Publication History

Article published online:
23 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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